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Bariatric Endocrinology

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Bariatric Endocrinology

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Abstract

A persistent positive energy balance leads to the accumulation of fat mass and the gradual loss of health. Accrual of fat mass leads to overweight and obesity, which represent a continuum that is properly defined as a chronic disease. The rise in fat mass leads to physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes, each of which contributes to the disease process. With overweight and obesity, depending on the genetic predisposition, individuals cross thresholds beyond which they can no longer compensate for adipose tissue dysfunction to maintain metabolic homeostasis. The inability to compensate for adiposopathy precipitates metabolic diseases.

Bariatric endocrinology was conceived from the need to understand the role of adipose tissue as an endocrine organ and the adipocyte as an endocrine cell. Bariatric endocrinology addresses the causes of adiposopathy and the neuro-endocrinological derangements that result from these pathological changes in adipose tissue structure and function. Knowledge that adipose tissue becomes diseased, and that this in turn affects other organs, broadened the scope of endocrine practice. In addition to the well-established metabolic complications of overweight, obesity, and adiposopathy (which include diabetes mellitus, hypertension, dyslipidemia, hyperuricemia, and gonadal dysfunction), there may also develop hyperleptinemia, hypoadiponectinemia, hyperinsulinemia, dysregulation of gut peptides including GLP-1 and ghrelin, inflammatory milieu, and the strong risk of vascular disease.

Effective reductions of body fat (including intra-abdominal fat) are accomplished by treating overweight and obesity with the same principles of chronic disease management that we use for other diseases. Adiposopathy, overweight, and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications and to normalize adipose tissue function for the adiposopathic complications.

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Authors and Affiliations

  1. Minnesota Center for Obesity, Metabolism and Endocrinology, PA (MNCOME), Eagan, MN, USA

    J. Michael Gonzalez-Campoy

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  1. J. Michael Gonzalez-Campoy
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Correspondence to J. Michael Gonzalez-Campoy .

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Editors and Affiliations

  1. MNCOME, Eagan, MN, USA

    J. Michael Gonzalez-Campoy

  2. Mayo Clinic, Rochester, MN, USA

    Daniel L. Hurley

  3. University of Alabama - Birmingham, Birmingham, AL, USA

    W. Timothy Garvey

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Gonzalez-Campoy, J.M. (2019). Bariatric Endocrinology. In: Gonzalez-Campoy, J., Hurley, D., Garvey, W. (eds) Bariatric Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-95655-8_1

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  • DOI: https://doi.org/10.1007/978-3-319-95655-8_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-95653-4

  • Online ISBN: 978-3-319-95655-8

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